<html>
<head>
<title>Vehicle Details</title>
<jsp:include page="header.jsp" />
<link rel="stylesheet" href="template/css/blue.css" type="text/css" />
<link rel="stylesheet" href="template/css/blue_bg.css" type="text/css" />
</head>
<title>Vehicle Details</title>
<script type="text/javascript" language="javascript"
	src="template/js/page/vechileDetails.js">
	
</script>
<body>
	<fieldset>
		<legend>Enter Vehicle Details</legend>
		<form action="register" method="post" name="vehicleForm"
			onsubmit="return validtation()">
			<input type="hidden" name="action" value="vehicle-details-register" />
			<table>
				<tr>
					<td>Name<br></td>
					<td><jsp:useBean id="personalDetailsDto" scope="session"
							type="com.pks.autoInsurance.dto.PersonalDetailsDto" />
						${personalDetailsDto.firstName }</td>
				</tr>
				<tr>
					<td>Vehicle Type</td>
					<td><select name="type" id="type"
						onchange="javascript: listboxchange1(this.options[this.selectedIndex].value);">
							<option value="">Select Vehicle Type</option>
							<option value="2">Two Wheeler</option>
							<option value="4">Four Wheeler</option>
					</select>
					</td>
				</tr>
				<tr>
					<td>Make</td>
					<td><script type="text/javascript" language="javascript">
						document
								.write('<select name="make" onChange="javascript: listboxchange(this.options[this.selectedIndex].value);"><option value="">Select make</option></select>');
					</script>
					</td>
				</tr>
				<tr>
					<td>Model<span class="serr">*</span>
					</td>
					<td><script type="text/javascript" language="javascript">
						document
								.write('<select name="model"><option value="">Select model</option></select>');
					</script>
					</td>
					<td><span class="serr" id="modelType"> </span>
					</td>
				</tr>
				<tr>
					<td>Year</td>
					<td><select name="mfYear">
							<option>1970</option>
							<%
								for (int i = 1971; i <= 2011; i++) {
							%>
							<option value="<%=i%>"><%=i%></option>
							<%
								}
							%>
					</select>
					</td>
				</tr>
				<tr>
					<td>Vehicle Registration No.<span class="serr">*</span>
					</td>
					<td><input type="text" name="vehicleRegistrationNo">
					</td>
					<td><span class="serr" id="registration"> </span>
					</td>
				</tr>

				<tr>
					<td>Premium Detail</td>
					<td><select name="policyType" size="1"
						onchange="setOptions(document.vehicleForm.policyType.options
[document.vehicleForm.policyType.selectedIndex].value);">
							<option value=" " selected="selected">-select Premium
								Detail-</option>
							<option value="Bodily Injury">Bodily Injury</option>
							<option value="Collision">Collision</option>
							<option value="Medical Payment">Medical Payment</option>
							<option value="Physical Damage">Physical Damage</option>
					</select>
					</td>
					<td>Premium Amount<select name="policyAmount" size="1">
							<option value=" " selected="selected">-select-</option>
					</select>
					</td>
					<td><span class="serr" id="tpolicy"> </span>
					</td>
				</tr>


				<tr>
					<td></td>
					<td><input type="submit" value="Submit">
					</td>
					<td><input type="reset" value="Reset">
					</td>
				</tr>
				<tr>
					<td></td>
					<td><span class="serr">* Vehicle Registration must be
							Alpha Numeric </span>
					</td>
				</tr>
				<tr>
					<td></td>
					<td><span class="serr"> Should be of 6 characters </span>
					</td>
				</tr>
			</table>
		</form>
	</fieldset>
	<jsp:include page="footer.jsp" />
</body>
</html>